Max Koivisto, NRAEMT

Primary specialty

Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X

License

A0900516 Issued in MA

Practice address

629 Jacobs Ladder Road
Becket, MA 01223

Phone

(413) 623-5027

Fax

(413) 623-2062

NPI assigned

Oct 18, 2023

Last updated

Oct 18, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Town of Becket

  dba Becket Ambulance Department

  • Land Ambulance
  • Becket, MA
  • NPI 1306839410
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1194507772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 MAIN ST",
            "city": "BECKET",
            "state": "MA",
            "postal_code": "012233252",
            "telephone_number": "413-623-5027",
            "fax_number": "413-623-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 JACOBS LADDER ROAD",
            "city": "BECKET",
            "state": "MA",
            "postal_code": "01223",
            "telephone_number": "413-623-5027",
            "fax_number": "413-623-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIVISTO",
        "first_name": "MAX",
        "name_prefix": "Mr.",
        "credential": "NRAEMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "MA",
            "license": "A0900516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Keyes Bachrach, LICSW
• Roger P. Chabot, MSN, LCSW, LICSW
• Andrea Louise Della Monica
• Carol Elaine Fletcher, RN
• Tangela Marie Gauthier
• Thomas John Leclair
• Carrie-Ann Mead
• Lisa Piemont
• Cynthia Finn Potel, L.C.S.W.
• Lanny Rose Jr.

• Intermediate Emergency Medical Technician in Becket, MA
• Providers in Becket, MA by specialty
• Intermediate Emergency Medical Technician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.